Female genital cutting has always been seen as an ancient ritual practiced in Africa and to a lesser extent in the Middle East, but a new global assessment documents for the first time that it is widespread in one of the most populous countries in Asia: Indonesia, where almost half the women are estimated to have undergone it.

There has long been anecdotal evidence of the practice there, but the United Nations Children’s Fund estimated Thursday that 60 million women and girls there have been cut based on national survey data collected by the Indonesian government. The addition of Indonesia is largely responsible for raising the global tally of women and girls who have undergone the practice to 200 million from 130 million, and the number of countries where it is concentrated to 30 from 29.

“We knew the practice existed but we didn’t have a sense of the scope,” said Claudia Cappa, a statistics specialist for Unicef, which released the report. She said the new data from Indonesia showed that cutting was not just “an African problem.”

Experts in Indonesia said the practice there had largely involved a less drastic version of cutting, usually a surface scratch or nick, as compared with more severe disfiguring. The Indonesian government’s survey asked parents if their young daughters had undergone circumcision. Ms. Cappa said it was possible that there were some more severe cases in Indonesia, but she said the official Indonesian government definition of female circumcision was “an act of scratching the skin that covers the front of clitoris without injuring the clitoris.”

The Indonesian data is part of Unicef’s latest global update on female genital cutting, which shows that over all the practice is declining worldwide. For example, the percentage of girls ages 15 to 19 who have been cut has declined from 51 percent in 1985 to 37 percent today in the countries where the practice is concentrated.

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Lia Sarifah, who says she recalls her ceremony with pride, makes and sells ceremonial dresses for young girls’ circumcisions at her home in Jakarta.CreditEd Wray for The New York Times

Some countries have shown rapid and significant declines. In Egypt, where 97 percent of 15- to 19-year-olds were circumcised 30 years ago, the rate is now 70 percent. Burkina Faso has dropped from 89 percent to 58 percent, and Liberia from 72 percent to 31 percent.

Still, even as the United Nations advocates an end to cutting — and Unicef surveys report that men, women, boys and girls in many of the countries agree it should be eliminated — the practice persists. The Unicef report says that “current progress is insufficient to keep up with increasing population growth” and if trends continue the number of girls and women being cut “will rise significantly over the next 15 years.”

The data from Indonesia, the world’s most populous Muslim-majority nation, provides a snapshot of the prevalence of genital cutting in a country where secular and religious attitudes toward the practice are increasingly in conflict. Indonesian authorities tried to ban cutting 10 years ago, but religious authorities who consider it important for girls to undergo the ritual before marriage objected. In response, the government softened its stance, issuing regulations that directed cutting should be done only by medical professionals in a noninvasive way that does not injure girls and women.

The Indonesian survey reported that 49 percent of girls age 11 and younger had undergone female circumcision, mostly as infants, and more than half of the procedures were performed by midwives or other health professionals.

The practice is “regarded as part of our culture, or a confirmation that they will be officially ‘Islamized,’ ” Jurnalis Uddin, the chairman of the Center for Population and Gender Studies at Yarsi University in Jakarta, said in an email, adding that the practice “in Indonesia is mostly symbolic (no cutting at all).”

For Unicef and others who seek to eliminate the practice in all its forms, the fact that medical providers are performing the procedures is unwelcome because it can confer legitimacy on the practice. “We are very concerned with medicalization,” said Francesca Moneti, a child protection specialist with Unicef. “Medical personnel are looked up to and are seen as knowing what’s good for your girl.”

The Indonesian survey, conducted in 2013 as part of large general health questionnaire administered to 300,000 households, was the first time the government collected national data on the practice. Although the data applied only to girls age 11 and younger, Unicef officials extrapolated it to the entire female population given the practice’s deep roots there, Ms. Cappa said. Because Indonesia has such a large population, Unicef estimated that about 60 million women and girls in Indonesia have been cut. The survey found that the practice was reported in most provinces, but was more prevalent among urban and wealthier families.

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An invitation to attend an Indonesian girl’s circumcision.CreditEd Wray for The New York Times

Views of the practice among Indonesian women vary. Rena Herdiyani, vice chairwoman of Kalyanamitra, an Indonesian nongovernmental organization that lobbies the national government to ban all forms of cutting, wants the government to impose sanctions on people who perform circumcisions.

“They think it’s a family or cultural tradition, and an Islamic obligation, yet they can’t name any verses in the Quran about female circumcision,” she said.

But there are strong supporters like Lia Sarifah, 47, whose experience involved more than just a scratch and occurred when she was 7 because her parents wanted her to be old enough to remember it. She recalls shaking with fear as she lay down on a bed at her parents’ house on the island of Sulawesi, and said a traditional healer pushed up the hem of her new dress, holding a small traditional knife in his gloved hands. A few minutes later he stood up with a small sliver of her clitoris.

But Ms. Lia said she recalled that day not with anger or shame, but with pride.

“Even today, I believe in circumcision and support it,” she said, sitting on the floor of her Jakarta salon, where she also makes and sells ceremonial dresses for young girls’ circumcisions. “If we don’t, then we can’t be whole as women and we can’t marry.”

Conflicting views have influenced public policy toward cutting. In 2006, the Ministry of Health issued a document banning female circumcision by medical professionals. In response, in 2008, Indonesia’s top Muslim clerical body issued a nonbinding fatwa or edict saying female circumcision should be performed if requested, as long as the method was not physically or psychologically dangerous.

In 2010, the Ministry of Health, at the urging of the clerical body, issued a regulation saying female circumcision should be performed only by licensed doctors, midwives or nurses using safety and cleanliness procedures detailed by the ministry. But anti-cutting activists objected to the regulation, and in 2014 it was repealed. Unicef officials assert in their report that the repeal does not go far enough because it does not explicitly prohibit cutting or set penalties for those who perform the procedure.

In Jakarta, Fitri Yanti, a pregnant 30-year-old mother of two, said she did not understand what all the fuss was about. She said she was not mutilated during her circumcision, didn’t bleed at all and felt nearly no pain during or after the procedure. “Mutilation is horrible, but it’s not true that it happens here” in Indonesia, Ms. Fitri said. “They cannot stop us. It’s our tradition.”

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A version of this article appears in print on , Section A, Page 6 of the New York edition with the headline: Female Genital Cutting: Not Just ‘an African Problem’ . Order Reprints | Today’s Paper | Subscribe